tbuckley/cabot-search huggingface dataset:
Abstract 20: Effect of Dietary Sodium Reduction in Chronic Kidney Disease Patients With Albuminuria: Results of a Randomized Trial
Authors: Katherine T Mills, Jing Chen, Bernadette Nguyen, Hua He, Kirsten S Dorans, Gabriel I Uwaifo, Damodar Kumbala, Lawrence J Appel, Paul K Whelton, Jiang He
Journal: Circulation (2023)

Introduction: Albuminuria, an early marker of kidney damage, is a risk factor for chronic kidney disease (CKD) progression, cardiovascular disease (CVD), and death. Dietary sodium is a risk factor for elevated blood pressure, CVD, and all cause-mortality. It is particularly important in patients with CKD due to increased salt-sensitivity. It is unclear if dietary sodium reduction is associated with reduced albuminuria. Hypothesis: A low sodium diet will reduce albuminuria in patients with CKD. Methods: The Sodium Lowering and Urinary Protein Reduction (SUPER) Trial was a randomized, parallel trial testing the effect of a 24-week dietary sodium reduction intervention compared to usual diet on albuminuria in 151 CKD patients with albuminuria. Participants were eligible if they had an estimated glomerular filtration rate (eGFR) of 30-90 mL/min/1.73 m 2 and an albumin-to-creatinine ratio (ACR) of 30-1,500 mg/g. Intervention group participants received a dietician-led behavioral change intervention targeting sodium intake &lt;2,300 mg/day and those in the control group received no dietary intervention. Twenty-four hour urine samples and dietary recalls, blood pressure, weight, and questionnaire data was collected at baseline, 12 weeks and 24 weeks. Mixed effects models were used to examine the intervention effect. Results: Study participants were an average of 65.6 years old, 72% African American, and 48% women. Median baseline ACR was 180.3 mg/g in the intervention and 157.4 mg/g in the control group, respectively. Urinary sodium excretion was reduced by 15.5% and 0.0% in the intervention and control groups, respectively. Results for the primary and key secondary outcomes are presented in the Table. Conclusions: The dietician-led dietary sodium reduction intervention succeeded in significantly reducing dietary sodium and BP in patients with CKD and albuminuria. However, no significant differences were observed in ACR, albuminuria, or eGFR between treatment groups.
Abstract P172: Per- and Polyfluoroalkyl Substances (PFASs), Apolipoprotein and the Risk of Coronary Heart Disease: A Case-Control Pilot Study
Authors: Lu Zhu, Yang Hu, Molin Wang, Jeremy D Furtado, Philippe Grandjean, Frank M Sacks, Eric B Rimm, Qi Sun
Journal: Circulation (2023)

The association of PFASs with blood lipids, lipoproteins and apolipoproteins, and coronary heart disease (CHD) risk are inconsistent in previous studies. The aim of current study is to examine the potential association between plasma PFASs, blood lipoproteins and their subspecies defined by apolipoproteins, and whether PFASs are associated with CHD risk.A case-control study was conducted in 100 men and 102 women aged 45-70 years. We leveraged 101 participants from HPFS and NHS who were initially free of cardiovascular disease and developed a fatal or non-fatal myocardial infarction during follow-up, and randomly matched controls in a 1:1 ratio for age, smoking status, and date of blood draw. Seven plasma PFASs measurements were examined at baseline, including perfluorohexane sulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), total perfluorooctane sulfonic acid (PFOS), branched PFOS (brPFOS), linear PFOS (nPFOS), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), with all mean CVs &lt;20%. Pearson correlation was applied to study the relationship between PFASs, lipoproteins and subspecies; Conditional logistic regression model was conducted to test the association between PFASs and CHD risk; a mediating effect model was used to assess how blood lipids and apolipoprotein subspecies mediate the association between PFASs and CHD risk.After multivariable adjustments, we did not find significant associations between PFAS and lipids, except for PFHxS and high-density lipoprotein cholesterol (HDL-C) with a significant positive association (r=0.19, p=0.046). For subspecies with apolipoprotein (apo) C-III, we observed non-significant inverse associations between plasma PFAS concentrations and the subspecies of HDL-C, low-density lipoprotein cholesterol (LDL-C) and VLDL-C that contain only apoC-III. For those without ApoC-III, the directions of most associations are positive. Strong associations were demonstrated between PFNA, PFDA and HDL-C with ApoE (r=0.42, p=0.00004; r=0.27, p=0.004, respectively). In addition, elevated PFOS concentrations were associated with higher relative risk of CHD (HR=1.04, p=0.02), especially for branched PFOS (HR=1.18, p=0.003), and these association were largely dose dependent (PFOS: p for linearity = 0.009; brPFOS: 0.0007). Mediation analysis illustrated no mediating effect regarding blood lipids and apolipoprotein subspecies on the association of interest, except for HDL-C on the association between PFOS, nPFOS and CHD risk (%mediated=25%, p=0.03; %mediated=36%, p=0.03, separately).Our results suggest that there is a linear positive dose-response relationship between PFOS and CHD risk, but the association is probably not mediated by subspecies with/without Apo C-III or Apo E.
Abstract P213: A Behavioral Economics Workplace Healthy Eating Intervention Similarly Benefits Employees With and Without Chronic Disease Risk
Authors: Jessica Cheng, Douglas Levy, Jessica McCurley, Eric B Rimm, Anne N Thorndike
Journal: Circulation (2023)

Introduction: Workplace interventions using behavioral economics approaches may provide low-cost opportunities for promoting healthy lifestyle. It is unknown if employees at higher chronic disease risk are more likely to benefit from workplace health promotion programs than employees at lower risk. This analysis assessed the differential effect of a 12-month behavioral workplace healthy eating intervention on improving dietary choices of employees’ with and without chronic disease risk. Hypothesis: We hypothesized that the intervention effect on cafeteria food purchases and diet quality would be stronger among employees with chronic disease risk compared to those without. Methods: This was a secondary data analysis of the ChooseWell 365 RCT conducted among hospital employees to test the effect of personalized feedback, peer comparisons, and financial incentives on improving cafeteria purchases, dietary intake, and weight. All hospital cafeterias used traffic-light food labeling. Published main results showed an intervention effect on cafeteria purchases but not overall diet quality or weight change. Diet quality was calculated from dietary recalls and measured via the Healthy Eating Index (HEI-2015), scored 0-100 (healthiest). Healthy purchasing scores (HPS) were calculated for each participant, weighting purchases’ color categories (red=0, yellow=0.5, green=1), scaled from 0-100 (healthiest). HEI-2015 and HPS were calculated at baseline, 6, 12, and 24 months. Participants were classified as having chronic disease risk if they self-reported hypertension, hyperlipidemia, heart disease, stroke, pre-diabetes, diabetes, cancer or another serious illness at baseline. Mixed models with random effects were used to compare dietary changes by study arm and risk categorization adjusted for body mass index, age, and race. Results: Participants (N=562) were mostly female (80.3%) and white (81.1%) with a median (p25, p75) age of 42 (33, 55) years; 38.1% reported at least one chronic disease risk condition. There was no differential intervention effect on HPS at any timepoint by chronic disease risk (all p-interaction&gt;0.05): Among those with chronic disease risk, intervention participants increased HPS (unadjusted mean [SD]) from baseline through 24 months (68 [13] to 74 [13]) compared to control (68 [14] to 68 [16]). This was similar to the difference between intervention (67 [12] to 72 [13]) and control participants (69 [12] to 72 [12]) without risk. There was no differential intervention effect on HEI by chronic disease risk (all p-interaction&gt;0.05). Conclusions: The ChooseWell 365 behavioral intervention improved the healthfulness of cafeteria purchases of employees with and without chronic disease risk, suggesting that workplace health promotion programs can improve lifestyle behaviors that contribute to both the prevention and treatment of chronic disease.
Abstract P338: Circulating microRNA-19 and Cardiovascular Risk Reduction in Response to Weight-Loss Diets: The Preventing Overweight Using Novel Dietary Strategies (Pounds Lost) Trial
Authors: Qiaochu Xue, Yoriko Heianza, Xiang Li, Xuan Wang, Hao Ma, Minghao Kou, Jennifer Rood, George Bray, Frank M Sacks, Lu Qi
Journal: Circulation (2023)

Introduction: MicroRNA-19 (MiR-19) plays a critical role in cardiac development and cardiovascular disease (CVD). Hypothesis: We assessed the hypothesis that change in circulating miR-19 would be associated with changes in 10-year atherosclerotic CVD (ASCVD) risk and individual cardiovascular risk factors in a dietary weight-loss intervention. Methods: This study included 509 participants with overweight or obesity from the 2-year weight-loss diet intervention study (the POUNDS LOST trial) and with available data on circulating miR-19a/b-3p at baseline and 6 months. The primary outcome was the 6-month change in the ASCVD risk score, which estimates the 10-year probability of hard ASCVD events. Secondary outcomes were the change in each ASCVD component including blood pressure, lipid profiles, insulin resistance, glucose metabolism, and adiposity measures. Change in habitual physical activity and sleep disturbance were assessed from baseline to 6 months. Results: Circulating miR-19a/b-3p levels significantly decreased during the initial 6-month dietary intervention period (P=0.008, 0.0004, respectively). We found that greater decreases in log-transformed miR-19a/b-3p were related to a greater reduction in ASCVD risk (β[SE]=0.35 [0.13], P=0.01 for miR-19a-3p; β[SE]=0.33 [0.13], P=0.01 for miR-19b-3p) over 6 months. Similar positive associations were observed for changes in diastolic blood pressure with miR-19a/b-3p. Moreover, we found that sleep disturbance was significantly associated with reductions in miR-19a/b-3p from baseline to 6 months (P trend &lt;0.05). There were significant interactions between changes in miR-19a/b-3p and sleep disturbance for changes in ASCVD risk (P interaction&lt;0.005). Participants with greater decreases in miR-19a/b-3p with no/slight amount of sleep disturbance had a greater reduction of ASCVD risk from baseline to 6 months than those with moderate/great amount of sleep disturbance. In addition, changes in physical activity modified the associations between changes in miR-19a-3p and ASCVD risk. A greater decrease in miR-19a-3p was significantly associated with a greater reduction in ASCVD among participants with an increase in physical activity from baseline to 6 months. These positive associations were reversed and not significant among participants with no change/decrease in physical activity and moderate/great amount of sleep disturbance. Conclusions: In conclusion, decreased circulating miR-19 levels induced by dietary weight-loss interventions were related to a significant reduction in ASCVD risk, and such associations were more evident in people with no/slight amount of sleep disturbance and an increase in physical activity.
Abstract P149: Police Contact in Adolescence and Healthy Lifestyle Patterns During the Transition to Adulthood: A Longitudinal Study
Authors: Farah Qureshi, Dylan B Jackson
Journal: Circulation (2023)

Background: Considerable work finds that adverse childhood experiences may predispose cardiovascular disease (CVD) in adulthood. While youth contact with police is an increasingly common early life adversity with known health impacts, it remains understudied in cardiovascular research. This prospective study investigated whether encounters with police in adolescence were associated with CVD-related lifestyle factors during the transition to adulthood. Methods: Data came from the Panel Study of Income Dynamics Child Development and Transition to Adulthood Supplements (N=2,361). In 2002 and 2007, participants aged 10-19y reported how often they were stopped and questioned by the police in the past 6 months (never, once, 2+ times). In 2005-2019, biennial surveys were completed from age 18-28y assessing 5 healthy lifestyle factors: body mass index 18.5-25 kg/m 2 , 8-11h of sleep per night for those ≤19y or 6-9h of sleep per night for those ≥20y, non-smoking, no binge drinking, and engaging in regular physical activity. Participants who reported having these factors at each available follow-up assessment were defined as sustaining healthy patterns over time. Poisson regression models evaluated associations between police contact and sustained healthy patterns of both individual lifestyle factors and multiple factors (range=0-5). Sensitivity analyses excluded youth who reported being arrested by police. Differences by race and gender were evaluated via interaction terms. Results: In the overall sample, 9% of youth were stopped by police once and 9% twice or more. Separately, 5% reported a history of arrest. Both police stops and arrests were more common among Black youth (1 stop: 11%, 2+ stops: 11%, arrest: 8%) than White youth (1 stop: 7%, 2+ stops: 7%, arrest: 2%). After adjusting for study covariates, frequent police stops were associated with a lower likelihood of maintaining healthy sleep patterns (IRR 1 stop =0.79, 95% CI=0.52, 1.20; IRR 2+ stops = 0.42, 95% CI=0.23, 0.77), abstaining from binge drinking in young adulthood (IRR 1 stop =0.86, 95% CI=0.70, 1.04; IRR 2+ stops =0.74, 95% CI=0.59, 0.92), and sustaining healthy patterns of multiple lifestyle factors (IRR 1 stop =0.91, 95% CI=0.75, 1.09; IRR 2+ stops =0.71, 95% CI=0.58, 0.88). Associations with other lifestyle factors were comparable in magnitude but characterized by wide confidence intervals. Nearly identical associations were observed when excluding youth with a history of arrest. Tests for interaction found no evidence of moderation by race or gender. Conclusions: Youth contact with police is related to unhealthy lifestyle patterns during the transition to adulthood, which may have important consequences for cardiovascular health across the lifespan. Given the disproportionate burden of police contact experienced by Black youth, future research should consider its potential role as an early driver of CVD disparities.
Abstract P184: Systolic Dysfunction is Associated With Increased Occurrence and Worse Outcomes of Periprocedural Cardiovascular Adverse Events After Percutaneous Transluminal Coronary Angioplasty
Authors: Dennis D Kumi, Edwin Gwira-Tamattey, Ufuk Vardar, Sadichhya Karki, Birju Patel, Ayesha Abbasi
Journal: Circulation (2023)

Background: The percutaneous transluminal coronary angioplasty (PTCA) rate continues to increase nationwide, and better strategies to achieve negligible complication rates are required. Data on risk assessment specific to cardiovascular complications are limited. Hypothesis: The presence of systolic dysfunction is associated with increased frequency and adverse outcomes of periprocedural cardiovascular complications among patients undergoing percutaneous transluminal coronary angioplasty. Method: A retrospective cohort study was designed using data obtained from the 2016 to 2018 combined National Inpatient Sample (NIS) database. The current procedural terminology (CPT) Codes of ICD-10 were used to identify patients admitted for percutaneous transluminal coronary angioplasty. They were then dichotomized into two cohorts based on the presence of systolic dysfunction. Primary outcomes were death, length of stay, total charge, composite of all cardiovascular perioperative adverse events and composite of all cardiovascular perioperative adverse events and death. Secondary outcomes were individual cardiovascular perioperative adverse events for all PTCA admissions and subsequently for patients with post-PTCA cardiac dysfunction. Multivariate linear and logistic regressions were used to adjust for confounders. Results: There was a total of 1,176,340 admissions for percutaneous transluminal angioplasty among whom were 145,330 with systolic dysfunction. Details of study outcomes are summarized in table 1 below. Conclusion: Among inpatients who underwent PTCA, systolic dysfunction is associated with higher odds of; composite of all periprocedural cardiovascular adverse outcomes, and composite of death and periprocedural adverse outcomes. This is largely driven by increased odds of all-cause mortality and odds of periprocedural cardiac dysfunction, particularly with increased ventricular tachycardias and cardiogenic shock. There was increased length of stay and total charge.
Abstract P560: Pilot Study Reveals Excellent Agreement in the Diagnosis of Diabetes Between the Newly Developed Pastry Sugar Tolerance Test and the OGTT: Africans in America Study
Authors: Blayne R Schenk, Jamaiica Hurston, Jean de Dieu Gatete, Christopher W DuBose, Lilian Mabundo, Shanna Yang, Charlita Worthy, Ram Jagannathan, Amber B Courville, Anne E Sumner
Journal: Circulation (2023)

Introduction: Sub-Saharan Africa has the highest percentage of people in the world living with diabetes who are undiagnosed. To avoid end-organ damage, identification of undiagnosed diabetes needs prioritization. Glucola (75g glucose) used for the oral glucose tolerance test (OGTT) is expensive and rarely available in sub-Saharan Africa. Due to hemoglobinopathies, G6PD deficiency, and challenges associated with fasting, both A1C and fasting plasma glucose (FPG) may be diagnostically unreliable. As an alternative to the OGTT, we developed the Pastry Sugar Tolerance Test (PSTT). For the PSTT, pastry sugar (75g glucose powder) is dissolved in hot water. Pastry sugar is more widely available in sub-Saharan Africa and nine times less expensive than Glucola. Objective: Our goals were to determine the diagnostic agreement for the detection of diabetes between the OGTT and: (1) PSTT, (2) A1C and (3) FPG. Methods: The participants were 36 African-born Blacks enrolled in the Africans in America study (male: 67%; age: 42±10y (mean±SD); BMI: 28.5±5.2 kg/m2). At Visit 1, each enrollee had an OGTT, A1C and FPG. At Visit 2, which occurred 8±3 days after Visit 1, a PSTT was performed. Glucose tolerance status was based on glucose results from the OGTT. The kappa-statistic was used to determine the diagnostic agreement between the OGTT and each of the following: PSTT, A1C and FPG. Results: Based on the OGTT, diabetes, prediabetes and normal glucose tolerance occurred in 11%(4/36), 33%(12/36) and 56%(20/36) resp. For diabetes, diagnostic agreement between the OGTT and PSTT was excellent (κ=0.99) but much lower for the OGTT and A1C (κ=0.64) and the OGTT and FPG (κ=0.38) (Figure). Conclusions: This pilot study has revealed that for diabetes screening, the PSTT has excellent diagnostic agreement with the OGTT, is less expensive than the OGTT, and is more accurate than A1C or FPG.
Abstract 26: Plasma Metabolomic Profile of Adiposity in Childhood: Gen3G Study
Authors: Zhila Semnani-Azad, Patrice Perron, Luigi Bouchard, Marie-France Hivert
Journal: Circulation (2023)

Objective: Childhood obesity is associated with long-term adverse outcomes including increased risk of cardiometabolic diseases. The integration of metabolomics in determining metabolites specific to excess adiposity could identify novel markers of adverse adiposity accumulation and insights into the pathogenesis of obesity-related outcomes, but investigations in childhood are limited. Thus, our aim was to identify metabolite networks associated with adiposity in childhood using gold-standard measurements. Methods: This study used cross-sectional data from 329 children at mid-childhood (age 5.3 ± 0.3 years) from the Gen3G prospective pre-birth cohort. We quantified 1,038 plasma metabolites including 798 annotated and 240 unannotated molecules. We measured adiposity using the gold-standard dual-energy X-ray absorptiometry (DXA), as well as skinfold, waist circumference and body mass index (BMI). We applied weighted-correlation network analysis to identify networks of highly correlated metabolites. Spearman’s partial correlations were applied to determine the associations of adiposity measures with metabolite networks and individual metabolites, adjusting for age and sex, with false discovery rate correction. Results: We identified a network of 23 metabolites (MEmagenta on Figure), primarily comprised of lipids (primary and secondary bile acids metabolism sub-pathways), that showed positive correlations with DXA total and truncal fat (ρ adjusted = 0.11 to 0.19), skinfold measures (ρ adjusted = 0.09 to 0.26), and BMI and waist circumference (ρ adjusted = 0.15 and 0.18, respectively). Within this network, glycol-alpha-muricholate and glycol-beta-muricholate metabolites, bile acid sub-species associated with glucose and lipid metabolism, appeared to be driving the associations. These correlations remained consistent when stratified by sex. Conclusions: A unique network of metabolites was associated with adiposity measures at 5 years of age.
Abstract 45: Life's Essential 8 and the Risk of Stroke in Finnish Men: The Kuopio Ischaemic Heart Disease Risk Factor Study
Authors: Nzechukwu M Isiozor, Setor K Kunutsor, Ari Voutilainen, Jussi Kauhanen, Xavier Jouven, Bamba Gaye, Jari A Laukkanen
Journal: Circulation (2023)

Background: Primordial prevention is an important way towards reducing risk of stroke with its associated health and economic burdens. So far, no study has shown how the recently updated American Heart Association’s cardiovascular health metrics, Life’s Essential 8 (LE8), relates to stroke events. Therefore, we sought to examine the association between LE8 and the risk of stroke among Finnish men. Methods: We employed the population-based Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) comprising men, aged 42 to 60 years, without pre-existing history of stroke at baseline. The LE8 was computed for 2614 men using AHA’s recently updated metrics. The LE8 includes four health behaviours (diet, physical activity, nicotine exposure, and sleep health) and four health factors (BMI, blood lipids, blood glucose and blood pressure). Each factor had points ranging from 0 to 100. Participants were classified into quartiles based on LE8 scores - Q1, ≤ 420; Q2, &gt;420 to 485; Q3, &gt;485 to 550; Q4, &gt;550. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of LE8 scores for stroke event. Results: During a median follow-up of 26 years, 446 stroke events were recorded. The higher the LE8 scores, the more protection from future risk of stroke event. Thus, per quartile increase was associated with 26% lower risk of stroke (HR:0.74; 95%CI:0.68-0.82). Men within the 4 th quartile (Q4) of LE8 score had the highest protection (65%) from risk of stroke when compared with those within the 1 st quartile (Q1) (HR: 0.45; 95%CI:0.34-0.60). Conclusion: Life’s Essential 8 was strongly and inversely associated with the risk of stroke among middle-aged and ageing Finnish men. Measures that promote LE8 should be encouraged among the general population in Finland.